(2016). Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial. Scandinavian Journal of Caring Sciences, 30(1), pp. 74-82. doi: 10.1111/scs.12223 This is the accepted version of the paper.This version of the publication may differ from the final published version. Keywords: pre-operative self-efficacy; pain management; hip/ knee replacement.
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Authors Contributions:MC, RW, LMA, AF, SP all contributed to study conception/design MC, RW, AF, SP, RC all contributed to various aspects of data collection/analysis All authors provided critical review of the content of the manuscript.
Acknowledgements:The authors would like to acknowledge to contributions of Barbara Jones, Fiona Cheung, Ivet Strijdom and Michelle Weston in assisting with recruitment and data collection.
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AbstractBackground: Hip and knee replacement is a major surgical procedure performed worldwide.
BackgroundBest practice guidelines to promote breastfeeding suggest that (i) mothers hold their babies in naked body contact immediately after birth, (ii) babies remain undisturbed for at least one hour and (iii) breastfeeding assistance be offered during this period. Few studies have closely observed the implementation of these guidelines in practice. We sought to evaluate these practices on suckling achievement within the first hour after birth.MethodsObservations of seventy-eight mother-baby dyads recorded newborn feeding behaviours, the help received by mothers and birthing room practices each minute, for sixty minutes.ResultsDuration of naked body contact between mothers and their newborn babies varied widely from 1 to 60 minutes, as did commencement of suckling (range = 10 to 60 minutes). Naked maternal-infant body contact immediately after birth, uninterrupted for at least thirty minutes did not predict effective suckling within the first hour of birth. Newborns were four times more likely to sustain deep rhythmical suckling when their chin made contact with their mother’s breast as they approached the nipple (OR 3.8; CI 1.03 - 14) and if their mothers had given birth previously (OR 6.7; CI 1.35 - 33). Infants who had any naso-oropharyngeal suctioning administered at birth were six times less likely to suckle effectively (OR .176; CI .04 - .9).ConclusionEffective suckling within the first hour of life was associated with a collection of practices including infants positioned so their chin can instinctively nudge the underside of their mother’s breast as they approach to grasp the nipple and attach to suckle. The best type of assistance provided in the birthing room that enables newborns to sustain an effective latch was paying attention to newborn feeding behaviours and not administering naso-oropharyngeal suction routinely.
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